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Sustaining Relationships and Expanding Support

By Madelyn Miller, CSW, ACSW, Chair of The Disaster Trauma Working Group

(October 2001)

As the weeks unfold since the profound tragedy of September 11th, 2001, and we feel its pervasive impact on wide dimensions of our individual, community, and societal reality, it seems timely to turn a focus to our own experience.

We have stepped into these weeks unfamiliar with the vast territory of these events, struggling to metabolize the enormity of this disaster. Our place within our own world is no longer the same. Each of us has changed. Safety, security, and predictability is forever challenged and uncertainty has been introduced into our lives. We have taxed our energies in personal and professional realms, struggling to help, participate, and respond, as we attempt to meet the expansive need facing us, and somehow lessen our own helplessness during a time of having little control. We bring our unique vulnerabilities and histories, and the demands of our lives. Yet we have lived through these weeks, collectively, and we continue to bear witness, together. While we certainly need to recognize the exact impact of this catastrophe, attend to balancing our work, and concretely nurture ourselves, it seems it is the sustaining of our relationships and the development of expanded networks of support that can provide us with the strongest foundation for this time.

The inevitable experience of exhaustion, as we progress from shock and disbelief to anxiety and profound sadness, compounded by the nature of our direct work with complex issues of trauma and loss, requires a generous response. Our experience as social workers, across diverse settings and numerous formal and informal roles, assumes our engagement with the most difficult issues of this catastrophe. Whether we work with those having prolonged exposure to the disaster site, suffering acute trauma reactions, or we work with families of those lost, suffering from prolonged and complicated traumatic loss, whether we work with those whose previous experiences of trauma are inevitably revisited, & we work with myriad others across the New York community who have endured this tragedy, or we conscientiously embrace those individuals and communities most vulnerable as a result of this disaster, we bring a deep sense of responsibility to our work.

Need for understanding

The cumulative experience of empathic attunement can be felt by each of us in clear and in subtle ways. Our efforts with clients and patients, to normalize (with the exception of those who are unable to minimally function in their daily lives) the broadest spectrum of reactions characteristically following such massive human-made catastrophe, can become a reminder that we, too, must normalize but conscientiously address the range of responses with which we are confronted. Whether it is sleeplessness, poor concentration or memory, anxiety, depression, or disengagement that we feel, or it is a sense of isolation, fear, or demoralization, it is the thoughtful and deliberate attention to our experience in relation to others which can ensure regaining a sense of integrity, in personal and professional realms.

Challanges ahead

Parallel to our concern for clients' immediate and long term responses to disaster trauma and loss, we can anticipate our own needs not only for early but also for continuous support. The intensity of the atmosphere surrounding this trauma, and the complexity of the continuum of expected reactions as they change over time and become uniquely expressed, challenge us deeply. Creating avenues of support among our diversity, as we legitimize the need to share our experience and its impact, and establishing sustaining connections, inevitably offer a new sense of safety, the context of community, and the experience of continuity. As we marvel at the human capacity to thrive in the midst of often life-threatening experience, recognizing exquisite sensitivity and equal resiliency in the face of tragedy, it seems it is the attachments and bonds to others that can best afford us meaning, hope, and active social engagement.